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近期起病的抽动障碍患儿的抽动抑制情况可预测1年抽动转归。

Tic Suppression in Children With Recent-Onset Tics Predicts 1-Year Tic Outcome.

作者信息

Kim Soyoung, Greene Deanna J, Robichaux-Viehoever Amy, Bihun Emily C, Koller Jonathan M, Acevedo Haley, Schlaggar Bradley L, Black Kevin J

机构信息

1 Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.

2 Department of Radiology, Washington University School of Medicine, St Louis, MO, USA.

出版信息

J Child Neurol. 2019 Oct;34(12):757-764. doi: 10.1177/0883073819855531. Epub 2019 Jun 26.

Abstract

Successful voluntary tic suppression is a key component of the behavioral interventions that are used to treat tic disorders. This study aimed to examine tic suppression in children with recent-onset tics and determine whether the capacity to suppress tics predicts future tic severity. We tested 45 children (30 male, mean age 7.74 years) with recent-onset tics (mean 3.47 months prior to the first study visit; baseline) and re-examined each child at the 12-month anniversary of the first recognized tic (follow-up). At the baseline visit, children performed a tic suppression task with several conditions: tic freely, inhibit tics given a verbal request, and inhibit tics in the presence of a reward. At the baseline visit, children with tics for only a few months could suppress their tics, and tic suppression was especially successful when they received an immediate and contingent reward. Additionally, the ability to suppress tics in the presence of a reward predicted tic severity at follow-up. These findings suggest that better inhibitory control of tics within months of tic onset may be an important predictor of future tic symptom outcome.

摘要

成功地自主抑制抽动是用于治疗抽动障碍的行为干预措施的关键组成部分。本研究旨在检查近期起病的抽动障碍患儿的抽动抑制情况,并确定抑制抽动的能力是否能预测未来抽动的严重程度。我们测试了45名近期起病的抽动障碍患儿(30名男性,平均年龄7.74岁)(首次研究访视前平均3.47个月;基线期),并在首次发现抽动的12个月纪念日(随访期)对每名患儿进行了重新检查。在基线访视时,患儿在几种情况下执行抽动抑制任务:自由抽动、在接到口头指令时抑制抽动、在有奖励的情况下抑制抽动。在基线访视时,患抽动仅几个月的患儿能够抑制他们的抽动,并且当他们获得即时和有条件的奖励时,抽动抑制尤其成功。此外,在有奖励的情况下抑制抽动的能力可预测随访期的抽动严重程度。这些发现表明,在抽动发作数月内对抽动进行更好的抑制控制可能是未来抽动症状转归的一个重要预测指标。

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